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States Form Vaccine Alliances and Issue Their Own Guidance as Federal Panel Revisits Policy

The alliances seek to preserve access by following major medical groups, with insurers guaranteeing no‑cost coverage only for the ACIP list as of Sept. 1 through 2026.

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New York State Governor Kathy Hochul speaks during a news conference about the coronavirus disease (COVID-19) vaccination mandate for healthcare workers, in New York City, U.S., September 27, 2021. REUTERS/David 'Dee' Delgado/File Photo
U.S. Health and Human Services Secretary Robert F. Kennedy Jr. testifies before the Senate Committee on Appropriations hearing on the Department of Health and Human Services budget, on Capitol Hill in Washington, D.C., U.S., May 20, 2025. REUTERS/Ken Cedeno/File Photo

Overview

  • California, Oregon, Washington and Hawaii formed the West Coast Health Alliance and released joint guidance for COVID-19, flu and RSV that recommends COVID shots for pregnant people and for children 6 to 23 months, departing from narrowed federal policy.
  • California enacted AB144, allowing the state to set its own immunization schedules based on guidance from groups such as AAP, ACOG and AAFP, and requiring insurers to cover authorized vaccinations.
  • Seven Northeastern states and New York City launched the Northeast Public Health Collaborative and issued COVID guidance recommending vaccination for infants 6 to 23 months and adults 19 and older, with vaccination optional for ages 2 to 18; Maryland later said it joined the group, which also lists Delaware.
  • The CDC’s Advisory Committee on Immunization Practices met for pivotal votes; the panel agreed that children under age 4 should receive measles-mumps-rubella and varicella as separate shots rather than the combined MMRV, with additional votes on COVID guidance pending.
  • Major insurers said they will continue no‑cost coverage for vaccines on ACIP’s list as of Sept. 1 through the end of 2026, while coverage for vaccines recommended only by state coalitions and implications for the Vaccines for Children program remain uncertain.